A former student recently told me that he believed
he was taught to offer patients options. I firmly told him that we now make recommendations.
Now, before my legal colleagues say that patients need options or we'll be in greater
legal liability, let me be clear. I'm saying, make a recommendation but say there
are options. Most patients expect us to tell them what's best for them. You get
paid for being a trained practitioner, and you need to be so confident in your recommendation
that you're willing to write it on a prescription form, even if it's an over-the-counter
product. If the patient chooses the recommendation, great! If it doesn't work, offer
an option.

We have great new products to recommend. Silicone hydrogels, better hydrogels, solutions
and specialty lenses. Here are some recent observations:

 Silicone hydrogels offer many benefits for most patients,
and we have a number of them. If one doesn't work due to deposits or GPC or whatever,
try another. They're not all the same. If you try a couple and they don't work,
there are new hydrogels that dehydrate less, are very biocompatible and work well
for daily wear. Also keep in mind that new daily disposable lenses help wet the
eye while they're worn. All of these lenses can be comfortable all day long if you
match each patient to the right lens and solution.

 Pay attention to the solutions your patients use. Make
sure that you understand from solution manufacturers about product and material
compatibility. And by all means, make sure patients are compliant with lens care
cleaning, rubbing, rinsing, fresh solution and a clean  even antimicrobial
 case.

 Many of you want to know what multifocal works. They all
do  and don't. Choose a multifocal and a bifocal and learn how to use them
well. Use a lab you can communicate with. Pick your presbyopes wisely and you'll
have great success.

Finally, I wrote a commentary in the July 30th issue of our Internet
publication CLToday (www.cltoday.com)about the possible introduction
of a lens made by a lab owned by a well-known Internet/mail-order company. I said
that a new lens, made of unknown material, in a unique package, would increase competition
and be good for the contact lens field. A few members of a popular message board
made what some of my colleagues felt were derogatory comments about me. Frankly,
I thought they were just naive, uninformed and paranoid remarks and I didn't want
to engage in such controversy, but I've been persuaded otherwise. They said these
things on-line and not to me. They said I'm an academic. Correct, guilty and proud
of it. They said, "What would an academic know about competition?" To those who
made these remarks, if you want to comment about me, my e-mail is cltoday@lwwvisioncare.com.
Please also understand that I'm responsible for an academic clinic that competes
in a very overpopulated eyecare practitioner city, and we compete very well. We
don't lose money because we recommend the best new products and we have smart people
in our organization, like most other academic clinics. We code well and we market
ourselves very productively. I hope you do, too.